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. 2023 Jul 17;24(1):579.
doi: 10.1186/s12891-023-06709-y.

Biomechanical analysis of different osteosynthesis configurations in the pin and plate fixation method for distal humerus fractures

Alireza Hakiminejad  1 , Amir Nourani  2 , Narges Ghias  1 , Alireza Mahmoudi  1 , Kaveh Same  3 , Reza Shahriar Kamrani  4 , Mohammad Hossein Nabian  5
Affiliations

Biomechanical analysis of different osteosynthesis configurations in the pin and plate fixation method for distal humerus fractures

Alireza Hakiminejad et al. BMC Musculoskelet Disord. .

Abstract

Distal humerus fractures commonly occur in adults with low bone mineral density causing major technical challenges for orthopedic surgeons. Persian fixation method was introduced as a novel technique to stabilize small fragments in comminuted distal humerus fractures using a set of K-wires and a reconstruction plate. The present study aims to measure this technique's stiffness and stability of this technique and analyze the effect of influential parameters with numerical simulation and biomechanical testing on a cadaveric specimen. Validation of the finite element (FE) model was conducted based on results of experiments. The results indicated that Delta configuration mainly led to a higher stiffness in the case of axial loading and anterior bending compared to L configuration. Analyzing the influential factors of this technique suggests that changes in diameter and number of K-wires have a similarly significant effect on the construct stiffness while the height of plate had a slight influence. Also, the diameter of wires was the most effective parameter for implant failure, particularly in the 3-pin construct, which caused a reduction in failure risk by about 60%. The results revealed that the Persian fixation method would achieve suitable stability compared to the dual-plating technique.

Keywords: Biomechanical testing; Distal humerus fracture; Osteosynthesis; Persian fixation method; Stability.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Research methodology for analyzing Persian fixation method.
Fig. 2
Fig. 2
Anteroposterior radiograph images of (a) Delta and (b) L configurations.
Fig. 3
Fig. 3
The loading and boundary conditions of FE models: (a) axial compressive loading, (b) anterior bending loading, (c) 3D meshing in FE model.
Fig. 4
Fig. 4
Configuration of implants on the cadaveric specimen.
Fig. 5
Fig. 5
Biomechanical testing setup for (a) compression and (b) anterior bending.
Fig. 6
Fig. 6
Displacement and von Mises contours for run number 7 of Table 3: (a) displacement under anterior bending, (b) von Mises stress under anterior bending, (c) displacement under axial loading, and (d) von Mises stress under axial loading. The displacement and stress values are in mm and MPa, respectively.
Fig. 7
Fig. 7
Main effect plots for the Delta models under (a) anterior bending and (b) axial loading.
Fig. 8
Fig. 8
Displacement and von Mises contours for run number 15 of Table 4: (a) displacement under anterior bending, (b) von Mises stress under anterior bending, (c) displacement under axial loading, and (d) von Mises stress under axial loading. The displacement and stress values are in mm and MPa, respectively.
Fig. 9
Fig. 9
Main effect plots for the L models under (a) anterior bending and (b) axial loading.
Fig. 10
Fig. 10
Load–displacement graphs of specimen under (a) anterior bending and (b) axial loading.
Fig. 11
Fig. 11
Displacement contours of the FE model built for validation with the cadaveric specimen under (a) anterior bending and (b) axial loading.
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